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2 New Job Opportunities
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[Guidance Overview]
RxDC Reporting for 2023
"Annual reporting is required by June 1 of each year. Calendar year 2023 data reporting is due June 1, 2024. Most employers sponsoring group health plans that provide prescription drug coverage, regardless of size or funding (fully insured or self-funded), have some
role to play in the RxDC process.... [This article provides] a refresher on the RxDC reporting requirements and responsibilities." MORE >>
AssuredPartners
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[Guidance Overview]
Health and Welfare Benefits Monthly Update, March 2024 (PDF)
27 presentation slides. Topics: [1] Washington update; [2] Update regarding STLDI and fixed indemnity regulations, and IRS News Release IR 2024-65; [3] Considerations for group health plan service agreements in light of recent legislation, regulation and litigation; [4] Drug importation issues; and [5] HIPAA developments. MORE >>
Alston & Bird
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[Guidance Overview]
Are HIPAA Covered Entities and Business Associates Required to Have a Risk Analysis and a Risk Management Plan? (PDF)
"The risk analysis ... must address all ePHI across the entire enterprise and identify deficiencies in compliance programs when compared to the HIPAA security rule. Based on the results of the risk analysis, the risk management plan is created to determine what safeguards
need to be implemented to bring the identified risks and vulnerabilities to a reasonable level." MORE >>
Thomson Reuters / EBIA
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Fifth Circuit Poised to Uphold Ruling Striking Down Preventive Coverage Requirement
"While the entire ACA preventive coverage framework is before the court, the oral arguments focused entirely on two issues: the constitutionality of the appointments of members of the Task Force and the appropriate remedy should the court side with the plaintiffs.... The
government also advanced arguments suggesting that Secretary Becerra's retroactive ratification of all Task Force recommendations and subsequent reappointment of its members resolved any remaining constitutional defects. The court seemed skeptical on the latter point." [Braidwood
Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Sep. 7, 2022; on appeal to 5th Cir. No. 23-10326)] MORE >>
Health Law Advisor, Epstein Becker Green
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Employers Have a Fiduciary Duty to Manage Their Prescription Drug Programs
"As a major drug maker itself, certainly J&J is presumed to understand the prescription drug market and industry practices. For companies using PBMs to provide prescription drug benefits to employees and beneficiaries, this complaint must serve as a warning ... [T]his
lawsuit is likely to spark significant interest into the opaque world of prescription drug plans and their pricing, which will undoubtedly lead to additional lawsuits." [Lewandowski v. Johnson & Johnson, No. 23-0671 (D.N.J. complaint filed Feb. 5, 2024)] MORE >>
Masuda Funai
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2022 Health Savings Account Account Balances, Contributions, Distributions, and Other Vital Statistics
"HSA balances continued to increase over the course of the year, despite higher spending on health care.... Accounts that received an employer contribution saw higher total contributions and were more likely to invest.... Most accountholders took a distribution in 2022....
Relatively few HSAs are invested.... Age and tenure play a major role in HSA utilization." MORE >>
Employee Benefit Research Institute [EBRI]
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Workers Cry for Choice: Employer Health Plans Leave Everyone Upset
"Last year's peak inflation rates will affect the health care sector in 2024 as multiyear contracts expire. Utilization remains high as Americans continue to catch up on nearly four years of treatments they may have missed or deferred during the pandemic.... Demand for pricey
specialty drugs such as GLP-1s for weight loss will further drive up costs across the industry. New regulations aimed at providing more transparency from pharmacy benefit managers and carriers will add to the administrative burden." MORE >>
BenefitsPro; free registration required
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HHS, UnitedHealth Struggle to Restore Paralyzed Billing Systems After Cyberattack
"The American Hospital Association calls the suspected ransomware attack on Change Healthcare, a unit of insurance giant UnitedHealth Group's Optum division, 'the most significant and consequential incident of its kind against the U.S. health care system in history.'
While doctors' practices, hospital systems, and pharmacies struggle to find workarounds, the attack is exposing the health system's broad vulnerability to hackers, as well as shortcomings in the Biden administration's response." MORE >>
KFF Health News
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Benefits in General |
[Official Guidance]
Text of IRS Notice 2024-28: Public Recommendations Invited on Items to Be Included on the 2024-2025 Priority Guidance Plan (PDF)
"The Department of the Treasury and the [IRS] invite the public to submit recommendations for items to be included on the 2024-2025 Priority Guidance Plan.... The 2024-2025 Priority Guidance Plan will identify guidance projects that the Treasury Department and the IRS intend to
actively work on as priorities during the period from July 1, 2024, through June 30, 2025." MORE >>
Internal Revenue Service [IRS]
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DOL Enforcement Actions Serve as Strong Reminder to Plans to Exercise Fiduciary Prudence
"Common areas [for] fiduciary breaches include [1] plan sponsors failing to timely remit employee contributions to the plan, particularly for off-cycle and manually cut checks; [2] plan committees not using best practices to monitor, choose, and remove plan investments
and not properly benchmarking performance and fees; and [3] plan fiduciaries relying heavily on third-party administrators to process claims without reviewing the claims letters and/or procedures being used by the third-party administrators." MORE >>
Haynes and Boone, LLP
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Employee Benefits Jobs
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Press Releases |
Pontera and AdvisorEngine Integration to Streamline Holistic 401(k) Management Capabilities for Advisory Firms
Pontera
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Last Issue's Most Popular Items |
IRS Reminds Taxpayers of Expenses Not Considered Medical Care and Therefore Not Reimbursable from FSAs, HSAs, HRAs and MSAs
Internal Revenue Service [IRS]
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J&J Case Practical Considerations: The Core Four ERISA Fiduciary Duties, Part 1
Newfront
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Weaving the Patchwork: How Mandatory Paid Family Leave Laws Stitch Together
Seyfarth Shaw LLP
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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.
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